Noridian to review cath claims
By HME News Staff
Updated 9:57 AM CST, Mon December 9, 2024
WASHINGTON – Noridian Healthcare Solutions, as the Supplemental Medicare Review Contractor (SMRC), is conducting post-payment review of intermittent urinary catheter claims billed with dates of service from Jan. 1, 2022, through Dec. 31, 2023. It’s reviewing HCPCS codes A4351, A4352 and A4353. Noridian noted that in February 2024, the Washington Post published an article alerting readers of an investigation into utilization for intermittent urinary catheters. As a result of the investigation, seven suppliers were identified in a scheme to bill claims for Medicare beneficiaries who either did not need the intermittent urinary catheters or did not receive them. In May 2024, Noridian completed research on HCPCS codes A4351, A4352 and A4353, and noted an increase in volume. In a recent bulletin, AAHomecare noted: “The SMRC is the third contractor now auditing intermittent catheters. Suppliers should carefully monitor the claims that are audited as the same claim cannot be audited by more than one auditor (excluding UPIC and CERT). If a supplier determines a claim has previously been audited, they should notify the contractor and it will be removed.” FMI: https://noridiansmrc.com/current-projects/01-130/.
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